HEDS is part of the School of Health and Related Research (ScHARR) at the University of Sheffield. We undertake research, teaching, training and consultancy on all aspects of health related decision science, with a particular emphasis on health economics, HTA and evidence synthesis.

Thursday, 6 November 2014

NICE on sipuleucel-T (Provenge)

£244,000 per QALY for a sub-group, £61,400 for a further sub-group and doesn’t meet end-of-life guidance.

The Committee noted that, for the sub-group of patients who had not had prior chemotherapy and using a discounted price for abiraterone, the cost per QALY (quality-adjusted life year) was at least £512,000 (company’s analyses) or at least £244,000 (Evidence Review Group’s analyses) for sipuleucel-T compared with abiraterone. When abiraterone was not included in the Evidence Review Group’s analysis, the cost per QALY for sipuleucel‑T compared with best supportive care was £112,000.

For the sub-group with baseline prostate-specific antigen levels of 22.1 ng/ml or below, the company’s original analyses resulted in a cost per QALY of £48,700 for sipuleucel‑T compared with best supportive care. The company’s revised analyses resulted in a higher cost per QALY. The Evidence Review Group’s exploratory analysis resulted in a cost per QALY of £61,400 for sipuleucel-T compared with best supportive care.

The Committee considered that the mean life expectancy for people with metastatic hormone-relapsed prostate cancer for which chemotherapy is not yet indicated was unlikely to be less than 24 months, so sipuleucel-T at this stage in the treatment pathway did not meet the first end-of-life criterion for short life expectancy.